Respiratory Drugs

Question 0

Terbutaline

Answer 0

Short acting Beta2 agonist (4-6h)

-Indications: acute treatment of the bronchospasm seen in asthma and COPD

Question 1

Albuterol

Answer 1

Short acting Beta2 agonist (4-6h)

-Indications: acute treatment of the bronchospasm seen in asthma and COPD

Question 2

Salmeterol

Answer 2

Longer acting Beta2 agonist (>12h)

-Indications: chronic treatment of the bronchospasm seen in asthma and COPD

Question 3

Zarfirlukast

Answer 3

Asthma drug. Blocks leukotriene receptors (CysLT1). Especially good for aspirin-induced asthma.

Question 4

Montelukast

Answer 4

Asthma drug. Blocks leukotriene receptors (CysLT1). Especially good for aspirin-induced asthma.

Question 5

Zileuton

Answer 5

Asthma drug. inhibitor of 5-lipoxygenase. Blocks conversion of arachidonic acid to leukotrienes. Hepatotoxic.

Question 6

Ipratropium bromide

Answer 6

Asthma drug. Muscarinic antagonist. Competitively blocks muscarinic receptors, preventing bronchoconstriction. Also used for COPD.

Question 7

Tiotropium bromide

Answer 7

Asthma drug. Long acting Muscarinic antagonist. Competitively blocks muscarinic receptors, preventing bronchoconstriction. Also used for COPD.

Question 8

Theophylline

Answer 8

Mathylxanthine asthma drug. Likely causes bronchodilation by inhibiting PDE–> increased cAMP levels due to decreased cAMP hydrolysis. Usage is limited because of narrow therapeutic index (cardiotoxicity, neurotoxicity). ,etabolized by cyp450. Blocks actions of adenosine.

in low to moderate doses: acts like caffeine

Acute intoxication: abdominal pain, vomiting, diarrhea, cardiac arrhythmias and SEIZURES (main concern!!)

Question 9

Fluticasone

Answer 9

Asthma drug. Inhibits synthesis of virtually all cytokines. Inactivate NF-kB, the transcription factor that induces production of TNF-alpha and other inflammatory agents. First line for chronic asthma.

Question 10

Omalizumab

Answer 10

Monoclonal Anti-IgE for anti-inflammatory control in asthma. Binds mostly unbound serum IgE and blocks binding to Fc.

Question 11

Diphenhydramine

Answer 11

First generation H1 blocker.

USES: allergy, motion sickness, sleep aid.

TOXICITY: sedation, Antimuscarinic, anti-alpha-adrenergic

Question 12

Dimenhydrinate

Answer 12

First generation H1 blocker.

USES: allergy, motion sickness, sleep aid.

TOXICITY: sedation, Antimuscarinic, anti-alpha-adrenergic

Question 13

Chlorpheniramine

Answer 13

First generation H1 blocker.

USES: allergy, motion sickness, sleep aid.

TOXICITY: sedation, Antimuscarinic, anti-alpha-adrenergic

Question 14

Loratadine

Answer 14

Second generation H1 histamine receptor blocker.

USES: allergy

TOXICITY: far less sedating than 1st generation because of decreased entry into CNS.

Question 15

Fexofenadine

Answer 15

Second generation H1 histamine receptor blocker.

USES: allergy

TOXICITY: far less sedating than 1st generation because of decreased entry into CNS.

Question 15

Desloratadine

Answer 15

Second generation H1 histamine receptor blocker.

USES: allergy

TOXICITY: far less sedating than 1st generation because of decreased entry into CNS.

Question 16

Cetirizine

Answer 16

Second generation H1 histamine receptor blocker.

USES: allergy

TOXICITY: far less sedating than 1st generation because of decreased entry into CNS.

Question 17

Guaifenesin

Answer 17

Expectorant–thins respiratory secretions; does not suppress cough reflex.

Question 18

N-acetylcysteine

Answer 18

Mucolytic–can loosen mucous plugs in CF patients by disrupting disulfide bonds. Also used as an antidote for acetaminophen toxicity.

Question 19

Dextromethorphan

Answer 19

Antitussive (antagonizes NMDA glutamine receptors). Synthetic codeine analog. Has mild opioid effect when used in excess. Naloxone can be given for overdose. Mild abuse potential. May cause serotonin syndrome if combined with other serotonergic agents.

Question 20

Pseudoephedrine

Answer 20

MOA: alpha adrenergic agonists, used as nasal decongestants.

USES: reduce hyperemia, edema, nasal congestion; open obstructed Eustachian tubes. Also illicitly used to make methamphetamine.

TOXICITY: hypertension. Can also cause CNS stimulation/anxiety

Question 21

Phenylephrine

Answer 21

MOA: alpha adrenergic agonists, used as nasal decongestants.

USES: reduce hyperemia, edema, nasal congestion; open obstructed Eustachian tubes.

TOXICITY: hypertension.

Question 22

Bosentan

Answer 22

endothelin receptor antagonist. Decreases pulmonary vascular resistance in pulmonary HTN. Hepatotoxic.

Question 23

Sildenafil

Answer 23

MOA: inhibits cGMP PDE5 and prolongs vasodilatory effect of NO.

USES: pulmonary HTN. Also for erectile dysfunction.

Question 24

Epoprostenol

Answer 24

Prostacyclin analog. Direct vasodilatory effect on pulmonary and systemic arterial vascular beds. Inhibits platelet aggregation. Flushing and jaw pain are side effects.

Question 25

Iloprost

Answer 25

Prostacyclin analog. Direct vasodilatory effect on pulmonary and systemic arterial vascular beds. Inhibits platelet aggregation. Flushing and jaw pain are side effects.

Question 26

Cromolyn

Answer 26

MOA: inhibits mast cell release of inflammatory mediators.

USES: prophylaxis for seasonal allergies, asthma, aspirin hypersensitivity, exercise-induced asthma

Question 27

Nedocromil

Answer 27

MOA: inhibits mast cell release of inflammatory mediators.

USES: prophylaxis for seasonal allergies, asthma, aspirin hypersensitivity, exercise-induced asthma